Knees Archive

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When you have knee pain, you just want it to go away so you can walk without having to limp or wince with every step. And a small, randomized trial published online Jan. 12, 2021, by Annals of Internal Medicine found that one type of shoe might be best for the job. Researchers took 164 people ages 50 or older with moderate or severe knee arthritis and randomly assigned half of the group to wear stable, supportive shoes with thick soles that didn't bend much. The other half was assigned flat shoes with thin, flexible soles, which are believed by some to provide a benefit by allowing more natural movement of the leg and foot. Both groups wore their assigned shoes for six hours per day and took part in activities such as walking during that time. After six months, 58% of people in the stable, supportive shoe group reported a reduction in knee pain while walking, compared with 40% of people reporting pain reduction after wearing the flat, flexible shoes. In both groups, the pain reduction probably was a benefit of regular walking. The people wearing flexible shoes were also twice as likely to develop ankle or foot pain, compared with those wearing sturdy shoes. So if you have knee pain, keep walking — in sturdy shoes.

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Men may avoid activity because of their knee pain, but movement is exactly what they need.

It is perhaps the ultimate exercise catch-22: it's hard to move with knee osteoarthritis, but moving helps relieve osteoarthritis knee pain.

More than 30 million Americans have osteoarthritis, the most common kind of arthritis. While osteoarthritis can affect the hips, lower back, neck, and fingers, it occurs most often in the knees. In fact, an estimated 10% of men ages 60 and older have symptoms of knee osteoarthritis.

Men may avoid activity because of their knee pain, but movement is exactly what they need.

It is perhaps the ultimate exercise catch-22: it's hard to move with knee osteoarthritis, but moving helps relieve osteoarthritis knee pain.

More than 30 million Americans have osteoarthritis, the most common kind of arthritis. While osteoarthritis can affect the hips, lower back, neck, and fingers, it occurs most often in the knees. In fact, an estimated 10% of men ages 60 and older have symptoms of knee osteoarthritis.

Ask the doctors

Q. I'm in my early 50s and am considering a knee replacement for severe arthritis. I've heard that doctors typically encourage people to wait until after age 60 to perform this procedure. Should I wait to have the surgery?

A. Doctors do sometimes recommend that people under age 60 wait to undergo a knee replacement procedure, because these artificial joints typically last only about 15 to 20 years. If someone younger gets the procedure, it's likely that the joint will need to be replaced again down the line. That said, the decision to have a joint replacement really depends more on your individual circumstances, such as how much pain you have, whether the problem is causing you significant disability, and your overall health, not just how old you are. Some people can safely wait until they are 60 to undergo the procedure without a problem. For others, waiting too long to have the knee replaced might not be advised. For example, if the knee joint deteriorates too much, that may make the surgery to replace it more challenging. Over all, most people (80% to 90%) who do opt for a knee replacement are happy with the results of the procedure, but it's best to discuss the pros and cons with your doctor.

An ailing knee or a hip can make life miserable. Even if your doctor recommends it be replaced, you need to carefully weigh the risks and benefits before agreeing to this major surgery and understand that it will require significant rehabilitation to get back on your feet.

The most important factor in choosing to have a knee or hip replaced is how much it hurts and how much it is affecting your life. Here are six signals that it's time to have a knee or hip replaced:

The first line of treatment for many knee and hip problems includes taking over-the-counter pain medications. Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are the most common pain medication options. However, these pain medications have a variety of side effects, so it's important to discuss your personal health risks with your doctor when considering long-term use for chronic conditions such as osteoarthritis.

Acetaminophen (Tylenol and other brands) is usually effective for mild pain and is easy on the stomach. However, it is toxic to the liver at high doses. The recommended maximum per day is generally set at 4 grams (4,000 milligrams), which is the equivalent of eight extra-strength Tylenol tablets. But that dosage can still cause liver problems for some people. To be safe, aim for 3,000 milligrams or less, and be cautious of mixing multiple products containing acetaminophen, such as a pain reliever and a cold medication or a prescribed narcotic.

These painful flare-ups can occur suddenly and for no apparent reason. Here's what you can do about them.

Have you ever woken up with a mysterious egg-shaped swelling on your elbow or knee and have no clue what caused it? There is a good chance you have bursitis.

"Bursitis is definitely more common as you get older and just comes with the territory of living a longer and more active life," says Dr. Robert Shmerling, senior faculty editor at Harvard Health Publishing and Corresponding Member of the Faculty of Medicine at Harvard Medical School.

Improving range of motion, muscle strength, and weight control can help reduce pain and make your knees feel younger.

Image: © jacoblund/Thinkstock

Knee pain is common in older age, often caused by osteoarthritis (the wearing away of knee cartilage). Fortunately, there are ways to fool Father Time and postpone knee problems or even prevent them entirely. "In many cases, you can delay or avoid the need for surgical intervention, such as a knee replacement," says Dr. Lars Richardson, an orthopedic surgeon with Harvard-affiliated Massachusetts General Hospital.

The aging knee

Your knees absorb a huge amount of pressure with every step — typically one-and-a-half times your body weight. That pressure, plus regular wear and tear, takes a toll over time. Muscles and ligaments get weaker. The knee's two shock absorbers — pads of cartilage called menisci — start to deteriorate. So does the articular cartilage protecting the ends of the leg bones where they meet at the knee. If you have a family history of osteoarthritis, if you're overweight, or if you've had some knee injuries, you may be more prone to this deterioration.

Osteoarthritis pain can be debilitating. Strategies can help get you moving again.

Pain from osteoarthritis is more than just a nuisance. Knee pain, in particular, can not only keep people from exercising, but also have a chilling effect on their ability to participate in social activities, especially those that involve walking or traveling, says Elena Losina, the Robert W. Lovett Professor of Orthopedic Surgery at Harvard Medical School and co-director of the Orthopaedic and Arthritis Center for Outcomes Research at Brigham and Women's Hospital.

"In fact, the quality of life of a person with persistent pain due to knee osteoarthritis is similar to quality of life in women with metastatic breast cancer controlled by therapy," she says.